Brain Function In Patients Research Articles

Resting-State Functional MRI Study Demonstrates That the Density of Functional Connectivity Density Mapping Changes in Patients with Acute Eye Pain.

PurposeBrain function in patients with acute eye pain (EP) has not been extensively studied. An understanding of the alterations in short-range functional connectivity density (shortFCD) and long-range functional connectivity density (longFCD) in patients with EP remains elusive. The aim of the present study was to compare the functional connectivity density (FCD) between patients with EP and healthy controls (HCs) using resting-state functional connectivity.MethodsA total of 40 patients with EP (26 males and 14 females) and 40 HCs (26 males and 14 females) of similar age underwent functional magnetic resonance (MR) examination at the resting state. The shortFCD and longFCD values were compared using the one-sample t-test. The differences between patients with EP and the HCs were evaluated using receiver operating characteristic (ROC) curves.ResultsIn the patients with EP, significantly reduced shortFCD values were observed in the left posterior lobe of the cerebellum, right inferior parietal lobule, and left anterior lobe of the cerebellum, and significantly reduced longFCD values were observed in both the left and right posterior lobe of the cerebellum. Significantly increased shortFCD values were also observed in both superior frontal gyri (Brodmann area 6), and increased longFCD values were observed in the left inferior temporal gyrus and left superior frontal gyri (Brodmann area 11). Compared with the HCs, less reduction was noted among the shortFCD values of patients with EP in the right posterior lobe of the cerebellum, right supramarginal gyrus, left middle temporal gyrus, bilateral superior frontal gyri, and bilateral caudate nuclei.ConclusionEP patients shown variation of binarized shortFCD and long FCD in brain areas including premotor cortex, ventral cortical visual system, newest part of the cerebellum, cerebellum control unconscious proprioception, inhibition of involuntary movement, somatosensory association cortex, nucleus involving reward system and ventral cortical visual system which might provide an explanation of brain functional compensation for chronic eye pain and visual impairment in the EP patients.

Когнітивна дисфункція у пацієнтів з артеріальною гіпертензією залежно від рівня загального холестеролу

SummaryObjective. Arterial hypertension (AH) is one of the most important risk factors forthe development of chronic vascular brain damage, significant symptoms of which arecognitive disorders.The aim of the research was to study the characteristics of the clinical picture,extracranial haemodynamics, indices of higher brain functions in patients with AH,depending on total cholesterol (TC) plasma level.Materials and methods. Were examined 157 patients (119 males, 38 females) whowere allocated into 3 groups according to the plasma level TC: the first group (n=48)included patients with the mean TC level (7.3±0.7) mmol/L; the second (n=58) group ofpatients with the TC level (5.8±0.8) mmol/L; the third (n=51) – with the TC level(4.7±0.5) mmol/L.Results. It was found that, with an increase in plasma TC level from the desiredlevel to a higher one, patients with AH develop the signs of chronic cerebral ischemia.The daily blood pressure profile is disturbed due to the insufficient degree of nightlydecline. The elastotonic characteristics of the vascular wall of the extracranial arterieschanges with the increase of the asymmetry of blood flow, which is accompanied withneurasthenic disorders of the anxious-depressive type as well as a significant decreasein cognitive functions.Conclusions. The severity of cognitive dysfunction must be taken into account whenconducting preventive measures and assessing the prognosis in patients with AH andconcomitant hypercholesterolemia.

Comparison of the accuracy of predicting prognosis of brain function in patients after cardiopulmonary cerebral resuscitation with two kinds of electroencephalogram techniques combined with neuron-specific enolase

Objective: To compare the accuracy of electroencephalography (EEG) grading or amplitude-integrated electroencephalography (aEEG) grading combined with NSE in predicting brain function prognosis after cardiopulmonary cerebral resuscitation (CPR) in adults. Methods: The patients who were admitted to Fujian Medical University Union Hospital after CPR from January 2015 to June 2019 were enrolled. Demographic data, Glasgow coma scale (GCS), blood neuron specific enolase (NSE), EEG grading and aEEG grading were collected. The main clinical outcome was the prognosis of brain function (Glasgow-Pittsburgh cerebral performance category, CPC) in patients at 3 months after CPR. Accordingly, the patients were divided into two groups: favorable prognosis group and poor prognosis group, and relevant parameters were compared between the two groups. The predictive ability of EEG grading or aEEG grading combined with NSE for brain function prognosis was evaluated by receiver operating characteristic (ROC) curve. Results: A total of 57 patients were enrolled, with 34 males and 23 females. The average age was (65±19) years old. In terms of Young EEG scales, there was 16 grade 1 cases (28.1%), 24 grade 2-5 cases (42.1%) and 17 grade 6 cases (29.8%), respectively. As for aEEG grading, there was 11 grade Ⅰ cases (19.3%), 25 grade Ⅱ cases (43.9%) and 21 grade Ⅲ cases (36.8%), respectively. There was no significant difference of age, sex, length of stay between the two groups (all P>0.05). However, there was significant difference of EEG grading scale, aEEG grading, GCS grading and NSE between the two groups (all P<0.05). The area under curve (AUC) of NSE, EEG grading and aEEG grading for predicting brain function prognosis was 0.81, 0.82 and 0.85, respectively (all P<0.01). In aEEG grading combined with NSE group, the AUC of was 0.92, and the optimal cut-off point was 4.5, with a sensitivity of 95.8% and a specificity of 79.0%. In EEG grading combined with NSE group, the AUC was 0.90, and the optimal cut-off point was 3.6, with a sensitivity of 92.1% and a specificity of 77.0%. Conclusions: aEEG grading combined with NSE is more accurate in predicting prognosis in patients with cardiopulmonary cerebral resuscitation when compared to EEG grading. Considering its feasibility, aEEG grading combined with NSE is more suitable for clinical application.

Permanent brain arrest as the sole criterion of death in systemic circulatory arrest.

Historically, there has been a tendency to think that there are two types of death: circulatory and neurological. Holding onto this tendency is making it harder to navigate emerging resuscitative technologies, such as extracorporeal membrane oxygenation and the recent well-publicised experiment that demonstrated the possibility of restoring cellular function to some brain neurons 4h after normothermic circulatory arrest (decapitation) in pigs. Attempts have been made to respond to these difficulties by proposing a unified brain-based criterion for human death, which we call 'permanent brain arrest'. The clinical characteristics of permanent brain arrest are the permanent loss of capacity for consciousness and permanent loss of all brainstem functions, including the capacity to breathe. These losses could arise from a primary brain injury or as a result of systemic circulatory arrest. We argue that permanent brain arrest is the true and sole criterion for the death of human beings and show that this is already implicit in the circulatory-respiratory criterion itself. We argue that accepting the concept of permanent cessation of brain function in patients with systemic permanent circulatory arrest will help us better navigate the medical advances and new technologies of the future whilst continuing to provide sound medical criteria for the determination of death.

Effect of acupuncture and its influence on cerebral activity in patients with persistent asthma: study protocol for a randomized controlled clinical trial

BackgroundPrevious studies suggested that acupuncture was a promising adjunctive treatment for asthma. However, the underlying mechanism of acupuncture for asthma remains unclear. The aim of the present trial is to explore whether and how specific meridian acupuncture works in quality of life and symptomatic improvement by modulating brain function in patients with asthma.Methods/designThis is a randomized controlled functional brain imaging trial currently being conducted in Sichuan, China. In total, 48 patients with mild to moderate persistent asthma will be recruited randomly and allocated to either of two acupuncture groups: acupuncture at the lung meridian or acupuncture at the heart meridian. The treatment period will last 4 weeks. The Asthma Quality of Life Questionnaire is the primary outcome. The Asthma Control Test, peak expiratory flow rate, forced expiratory volume in 1 s, Montreal Cognitive Assessment, Zung Self-rating Anxiety Scale, and Zung Self-rating Depression Scale will also be used to assess the clinical efficacy of different interventions. Functional magnetic resonance imaging (fMRI) will be performed to detect cerebral activity changes in each group. The clinical data and fMRI data will be analyzed between groups, then, the Pearson correlation analysis will be used to assess the association between the changes of cerebral activity features and the improvement of clinical outcomes in each group.DiscussionThe present study has been established on the basis of the “meridian–viscera relationship” theory of traditional Chinese medicine and the modern central mechanism of acupuncture. The results of this trial would be useful to identify the efficiency of the specific meridian acupuncture for asthma. The investigation of its central mechanism would further expand knowledge of acupuncture for asthma.Trial registrationChinese Clinical Trial Registry, ChiCTR1900027478. Registered on 15 November 2019.

Novel Treatment for the Most Resistant Schizophrenia: Dual Activation of NMDA Receptor and Antioxidant.

Clozapine has been regarded as the last-line antipsychotic agent for patients with refractory schizophrenia. However, many patients remain unresponsive to clozapine, referred to as "clozapineresistant", "ultra-treatment-resistant", or remain in incurable state. There has been no convincing evidence for augmentation on clozapine so far. Novel treatments including numerous N-methyl-Daspartate (NMDA) receptor (NMDAR) enhancers, such as glycine, D-serine, D-cycloserine, and Nmethylglycine (sarcosine) failed in clinical trials. Earlier, the inhibition of D-amino acid oxidase (DAAO) that may metabolize D-amino acids and activate NMDAR has been reported to be beneficial for patients with schizophrenia receiving antipsychotics except for clozapine. A recent randomized, double-blind, placebo-controlled clinical trial found that add-on sodium benzoate, a DAAO inhibitor, improved the clinical symptoms in patients with clozapine- resistant schizophrenia, possibly through DAAO inhibition (and thereby NMDAR activation) and antioxidation as well; additionally, sodium benzoate showed no obvious side effects, indicating that the treatment is safe at doses up to 2 g per day for 6 weeks. More studies are warranted to elucidate the mechanisms of sodium benzoate for the treatment of schizophrenia and the etiology of this severe brain disease. If the finding can be reconfirmed, this approach may bring new hope for the treatment of the most refractory schizophrenia. This review summarizes the current status of clinical trials and related mechanisms for treatmentresistant, especially, clozapine-resistant schizophrenia. The importance of understanding the molecular circuit switches is also highlighted which can restore brain function in patients with schizophrenia. Future directions in developing better treatments for the most difficult to cure schizophrenia are also discussed.

Short-Term Effects of Flupentixol-Melitracen on Regional Brain Function in Patients with Irritable Bowel Syndrome: An fMRI Study

Background: The efficacy of the treatment for irritable bowel syndrome (IBS) with the combination of anxiolytic/antidepressant has been confirmed by clinical studies, but the central mechanism is unclear. Objectives: To investigate the effects of flupentixol-melitracen, a mixture of tricyclic antidepressant and a classical antipsychotic component, on resting-state brain function in IBS patients by using functional magnetic resonance imaging (fMRI). Patients and Methods: Thirty-two patients with IBS were randomly divided into an observation group (OG, n = 16) and control group (CG, n = 16). All patients in both groups were given spasmolytic agent (pinaverium bromide). For the OG group, flupentixol-melitracen was added. FMRI scans were performed in all patients before and four weeks after the therapy. The scores of gastrointestinal symptom rating scale (GSRS), Hamilton depression scale (HAMD-17) and anxiety scale (HAMA-14) were evaluated at the same time. FMRI regional homogeneity (ReHo) parameters were compared between the two groups before and after treatment using a 2 (therapy) × 2 (time) mixed model analysis of variance (ANOVA) statistical method, and were correlated with the changes of GSRS, HAMD and HAMA scores in the two groups. Results: The fMRI results of the mixed-model analysis of covariance (ANCOVA) and post analyses were as follows. When the therapeutic factor was the main effect, ReHo was increased in the left superior and middle occipital gyrus, and the left parietal gyrus, and decreased in the left thalamus and the lenticular nucleus in both groups after treatment when compared to the unmedicated state. In addition, the OG group showed decreased ReHo in the left superior temporal gyrus, the right lenticular-putamen nucleus, the right inferior frontal gyrus, the right insula, the right gyrus rectus and subcallosal gyrus. The CG group showed increased ReHo in the right angular gyrus. When the interaction between therapy and time was the main effect, the brain region with different ReHo values was in the left precuneus. In the OG group, the change of ReHo in the left precuneus was negatively correlated with the decrease of HAMD and HAMA scores. Conclusion: Flupentixol-melitracen can effectively improve anxiety, depression and gastrointestinal symptoms in patients with IBS, which may be related to the reversal of abnormal neural activity in the brain regions within the default network and the prefrontal-limbic-temporal emotional circuit in IBS patients.

Functional Integration and Segregation in Multiplex Brain Networks for Alzheimer's Disease.

Growing evidence links impairment of brain functions in Alzheimer's disease (AD) with disruptions of brain functional connectivity. However, whether the AD brain shows similar changes from a dynamic or cross-frequency view remains poorly explored. This paper provides an effective framework to investigate the properties of multiplex brain networks in AD considering inter-frequency and temporal dynamics. Using resting-state EEG signals, two types of multiplex networks were reconstructed separately considering the network interactions between different frequency bands or time points. We further applied multiplex network features to characterize functional integration and segregation of the cross-frequency or time-varying networks. Finally, machine learning methods were employed to evaluate the performance of multiplex-network-based indexes for detection of AD. Results revealed that the brain networks of AD patients are disrupted with reduced segregation particularly in the left occipital area for both cross-frequency and time-varying networks. However, the alteration of integration differs among brain regions and may show an increasing trend in the frontal area of AD brain. By combining the features of integration and segregation in time-varying networks, the best classification performance was achieved with an accuracy of 92.5%. These findings suggest that our multiplex framework can be applied to explore functional integration and segregation of brain networks and characterize the abnormalities of brain function. This may shed new light on the brain network analysis and extend our understanding of brain function in patients with neurological diseases.

Instant analgesic effect of radial extracorporeal shock wave therapy on primary dysmenorrhoea according to functional magnetic resonance imaging: study protocol for a randomised placebo-controlled trial

BackgroundPrimary dysmenorrhoea (PDM) is defined as a series of pain-dominated symptoms during and after menstruation without organic lesions. Nonsteroidal anti-inflammatory drugs and oral contraceptives are usually recommended as first-line therapy for the clinical treatment of PDM, but their widespread long-term application is controversial. Radial extracorporeal shock wave therapy (rESWT) has been widely applied in musculoskeletal rehabilitation because of its secure and noninvasive characteristics and its confirmed effect in improving pain symptoms. This research seeks to explore the efficacy of rESWT for PDM and the changes in brain function of patients with PDM.MethodsThis clinical research will be a randomised, blind, sham-controlled trial. Thirty-six patients with PDM will be randomly divided into the rESWT group (n = 18) and the sham rESWT group (n = 18). In the rESWT group, treatment will be applied once within 48 h of menstruation at six abdominal myofascial trigger points. The sham rESWT group will receive sham shockwave therapy on the same sites but without energy input. Other dysmenorrhoea-related treatments in both groups will be limited. The main indicators include the short form of the McGill Pain Questionnaire and the Cox Menstrual Symptom Scale. The secondary indicators include the Zung Self-rating Anxiety Scale and Self-rating Depression Scale and functional magnetic resonance imaging (fMRI) changes in brain regions. Results will be evaluated at the screening, at baseline, and before and after treatment, and adverse treatments will be examined. Inter- and intragroup analyses will be performed.DiscussionThis randomised controlled study is designed to explore the immediate efficacy of rESWT for PDM. After rESWT treatment, PDM symptom tests and pain tests, as well as fMRI data, will be investigated for the potential connections between immediate neuroanalgesic mechanisms, which are associated with pain and brain networks. The main results will be used to assess the efficacy of rESWT, and secondary results will focus on improving the neurobiological understanding of disease treatment.Trial registrationChina Clinical Trial Register, ChiCTR1900020678. Registered on 13 January 2019.

Therapeutic evidence of umbilical cord-derived mesenchymal stem cell transplantation for cerebral palsy: a randomized, controlled trial

BackgroundCerebral palsy (CP) is a syndrome of childhood movement and posture disorders. Clinical evidence is still limited and sometimes inconclusive about the benefits of human umbilical cord mesenchymal stem cells (hUC-MSCs) for CP. We conducted a randomized trial to evaluate the safety and efficacy of hUC-MSC transplantation concomitant with rehabilitation in patients with CP.MethodsEligible patients were allocated into the hUC-MSC group and control group. In addition to rehabilitation, the patients in the hUC-MSC group received four transfusions of hUC-MSCs intravenously, while the control group received a placebo. Adverse events (AEs) were collected for safety evaluation in the 12-month follow-up phase. Primary endpoints were assessed as activities of daily living (ADL), comprehensive function assessment (CFA), and gross motor function measure (GMFM) scales. In addition, cerebral metabolic activity was detected by 18F-FDG-PET/CT to explore the possible mechanism of the therapeutic effects. Primary endpoint data were analyzed by ANOVA using SPSS version 20.0.ResultsForty patients were enrolled, and 1 patient withdrew informed consent. Therefore, 39 patients received treatments and completed the scheduled assessments. No significant difference was shown between the 2 groups in AE incidence. Additionally, significant improvements in ADL, CFA, and GMFM were observed in the hUC-MSC group compared with the control group. In addition, the standard uptake value of 18F-FDG was markedly increased in 3 out of 5 patients from the hUC-MSC group at 12 months after transplantation.ConclusionsOur clinical data showed that hUC-MSC transplantation was safe and effective at improving the gross motor and comprehensive function of children with CP when combined with rehabilitation. Recovery of cerebral metabolic activity might play an essential role in the improvements in brain function in patients with CP. The therapeutic window, transfusion route, and dosage in our study were considerable for reference in clinical application.Trial registrationChictr.org.cn, ChiCTR1800016554. Registered 08 June 2018—retrospectively registered. The public title was “Randomized trial of umbilical cord-derived mesenchymal stem cells for cerebral palsy.”

Treatment-related changes towards normalization of the abnormal external signal processing in panic disorder.

Despite the scientific consensus on the efficacy of psychotherapy for the treatment of psychological disorders, the evidence of treatment-related changes towards normalization of abnormal brain functions in patients is mixed. In the present experiment, we investigated whether treatment can affect early information processing, by testing abnormal event-related potentials (ERPs) evoked by internal and external signals in panic disorder. Sixteen patients with panic disorder and comorbid personality disorder and sixteen control participants performed a response-choice task and a passive viewing task in two testing sessions, separated by around 14 months. During this period, patients received psychological treatment. In agreement with previous studies of performance monitoring, the abnormal amplitude of the Ne/ERN–an index of error processing based on internal signals—did not change between the first and second testing session. However, treatment-related changes were evident for the abnormal vertex positive potential (VPP) evoked by external signals in the response-choice task and the passive viewing task. In patients, the VPP was smaller in the second session compared to the first session, whereas no significant changes occurred in controls. This result supplies evidence of treatment-related changes towards normalization in the early information processing of external visual stimuli in panic disorder.

Effects of Ketosis on Brain Function in Patients With T1DM

Effects of Ketosis on Brain Function in Patients With T1DM

Visual Analysis of Epilepsy Diagnosis Based on Brain Functional Connections

Epilepsy is a transient neurological disorder associated with changes in the functional connections of the brain. Abnormal electrical discharges can be observed during an epileptic seizure. However, in the absence of an epileptic seizure, the anatomical structure of the brain and the electrical waves of the brain are not observed, making it difficult to explain the cause. This paper deals with together weighted imaging (DWI) sequence data in functional magnetic resonance imaging (FMRI) of epileptic patients before seizure, using Anatomical Automatic Labeling (AAL) template extracted 116 brain regions and the introduction of time series, a matrix of 116 × 116. Pearson correlation coefficient was calculated to investigate the pathological condition of brain function in epilepsy patients, using of neural network visualization system of innovative visual display and compared with the normal epileptic brain function to connect the image, with 38 cases of epilepsy by 187 cases of normal DWI experiment data, and can confirm the existence of brain function in patients with epilepsy connections. Cerebral neural network visualization system showed partial functional connection loss between frontal lobe and temporal lobe in epileptic group compared with normal control group.

Stress, the brain, and trauma spectrum disorders.

This chapter reviews the relationship between stress and brain function in patients with neuropsychiatric disorders, with an emphasis on disorders that have most clearly been linked to traumatic stress exposure. These disorders, which have been described as trauma spectrum disorders, include posttraumatic stress disorder (PTSD), a subgroup of major depression, borderline personality disorder (BPD) and dissociative disorders; they share in common a neurobiological footprint, including smaller hippocampal volume, and are distinguished from other disorders that may share symptom similarities, like some of the anxiety disorders, but are not as clearly linked to stress. The relationship between environmental events such as stressors, especially in early childhood, and their effects on brain and neurobiology is important to understand in approaching these disorders as well as the development of therapeutic interventions. Addressing patients with stress-related disorders from multiple developmental (age at onset of trauma) as well as levels of analysis (cognitive, cultural, neurobiological) approaches will provide the most complete picture and result in the most successful treatment outcomes.

Effect of acupuncture and moxibustion on brain functional connectivity network in patients with refractory facial paralysis

To observe the effects of acupuncture on resting-state functional connectivity (rs-FC) in patients with refractory peripheral facial paralysis, and to preliminarily explore the central mechanism of acupuncture for this disease. Twenty patients with refractory peripheral facial paralysis were selected as subject and treated with acupuncture at Qianzheng (EX-HN 16), Fengchi (GB 20), Cuanzhu (BL 2), Dicang (ST 4), Jiache (ST 6), Shuigou (GV 26), Chengjiang (CV 24), Yifeng (TE 17), Touwei (ST 8), Sibai (ST 2), Yingxiang (LI 20) and Hegu (LI 4), once every other day, three times a week, 15 times as a course of treatment. The 1-course treatment was given. The score of Sunnybrook (Toronto) facial grading system was used to evaluate the clinical efficacy before and after the treatment. In addition, 20 healthy volunteers were selected as control. For patients, the resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed before and after treatment, for healthy volunteers, the scans were performed when they were recruited. The brain magnetic resonance images were analyzed with left primary motor area (LMⅠ) and right primary motor area (RMⅠ) as regions of interest. The differences of rs-FC between patients with refractory peripheral facial paralysis before and after treatment and healthy volunteers were compared. Compared before treatment, the Sunnybrook score was increased after the treatment (P<0.05). Compared with healthy volunteers, the functional connection between bilateral primary motor areas (MⅠ) and multiple brain areas were enhanced in patients before treatment, and most of brain areas were located in the anterior motor area (middle frontal gyrus, superior frontal gyrus), posterior central gyrus, anterior cuneiform lobe, middle temporal gyrus, inferior temporal gyrus and cerebellum lobe. Compared before treatment, the left inferior frontal gyrus was the strong functional connection area between LMⅠ and whole brain after acupuncture treatment, and there was no significant difference between RMⅠ and resting-state whole brain. Compared with healthy volunteers, the functional connections between bilateral MⅠ and multiple brain regions were enhanced after acupuncture, and most of the main brain regions were consistent with those before treatment. (1) Acupuncture could effectively improve the clinical symptoms of refractory peripheral facial paralysis. (2) The brain function of patients with refractory peripheral facial paralysis has been changed before acupuncture, which may be caused by the reactive compensation of the brain. (3) Acupuncture could enhance the functional connection between LMⅠ and left inferior frontal gyrus to promote the compensatory response, which may be one of the central mechanisms of acupuncture for refractory peripheral facial paralysis.

Exercise Benefits in Patients Recovering from Traumatic Brain Injury

This paper aims to understand in what aspects exercise benefits traumatic brain injury patients. It examines the molecular basis of how exercise may facilitate cognitive recovery, discuss the clinical evidence of the benefits of exercise on cognition and mood impairments in patients, and identify potential barriers for patients recovering from traumatic brain injury from engaging in physical exercise. There are extensive reviews exploring the effect of exercise on patients recovering from traumatic brain injury. Exercise appears to have benefit in global cognition and mood. Exercise is a non-pharmacological and non-invasive therapy for improving brain function in patients recovering from traumatic brain injury. Exercise should be recommended for patients recovering from acute and chronic brain injury. It is seen to improve global cognition and mood impairments.

Biomechanical properties of the hypoxic and dying brain quantified by magnetic resonance elastography

Respiratory arrest is a major life-threatening condition leading to cessation of vital functions and hypoxic-anoxic injury of the brain. The progressive structural tissue changes characterizing the dying brain biophysically are unknown. Here we use noninvasive magnetic resonance elastography to show that biomechanical tissue properties are highly sensitive to alterations in the brain in the critical period before death. Our findings demonstrate that brain stiffness increases after respiratory arrest even when cardiac function is still preserved. Within 5 min of cardiac arrest, cerebral stiffness further increases by up to 30%. This early mechanical signature of the dying brain can be explained by water accumulation and redistribution from extracellular spaces into cells. These processes, together, increase interstitial and intracellular pressure as revealed by magnetic resonance spectroscopy and diffusion-weighted imaging. Our data suggest that the fast response of cerebral stiffness to respiratory arrest enables the monitoring of life-threatening brain pathology using noninvasive in vivo imaging. Statement of significanceHypoxia-anoxia is a life-threatening condition eventually leading to brain death. Therefore, monitoring vital brain functions in patients at risk is urgently required during emergency care or treatment of acute brain damage due to insufficient oxygen supply. In mouse model of hypoxia-anoxia, we have shown for the first time that biophysical tissue parameters such as brain stiffness changed markedly during the process of death.

Early assessment value of brain function prognosis in patients with traumatic brain injury by regional saturation of cerebral oxygenation combined with percentage of α variability

To explore the usability of regional saturation of cerebral oxygenation (rScO2) combined with percentage of α variability (PAV) in predicting brain function prognosis in patients with traumatic brain injury (TBI). A retrospective analysis was conducted. The clinical data of patients with TBI who were monitored rScO2 and bedside quantitative electroencephalogram (qEEG) admitted to intensive care unit (ICU) of Henan Provincial People's Hospital from August 2018 to July 2019 were collected. The rScO2, PAV, and Glasgow coma scale (GCS) score were recorded within 72 hours after the TBI. The primary prognostic indicator was the 3-month Glasgow outcome score (GOS) score. The differences between the two groups of poor prognosis of brain function (GOS score 1-3) and good prognosis (GOS score 4-5) were compared. Binary multivariate Logistic regression analysis was used to analyze the correlation between rScO2, PAV, GCS score and the prognosis of brain function in patients with TBI. In addition, receiver operating characteristic (ROC) curve was plotted to analyze the predicting value of rScO2 and PAV only or combination for prognosis of brain function. A total of 42 patients with TBI were enrolled in the study, with rScO2 ≥ 0.60 (grade I) in 14 patients, 0.50 ≤ rScO2 < 0.60 (grade II) in 16 patients, and rScO2 < 0.50 (grade III) in 12 patients. PAV 3-4 scores (grade I) were detected in 16 patients, 2 scores (grade II) in 17 patients, and 1 score (grade III) in 9 patients. GCS score 9-14 (grade I) were observed in 13 patients, 4-8 (grade II) in 23 patients, and 3 (grade III) in 6 patients; 18 patients had poor prognosis and 24 had good one. The rScO2, PAV and GCS scores of the poor-prognosis group were significantly higher than those in the good-prognosis group [rScO2 with grade III: 55.6% (10/18) vs. 8.3% (2/24), PAV with grade III: 38.9% (7/18) vs. 8.4% (2/24), GCS score with grade III: 27.7% (5/18) vs. 4.1% (1/24)] with significant differences (all P < 0.05). There was no significant difference in other general data including gender, age, total length of hospital stay or acute physiology and chronic health evaluation II (APACHE II) score between the two groups. Binary multivariate Logistic regression analysis showed that rScO2 and PAV were independent risk factors for prognosis of brain in patients with TBI [rScO2: odds ratio (OR) = 4.656, 95% confidence interval (95%CI) was 1.071-20.233, P = 0.040; PAV: OR = 3.525, 95%CI was 1.044-11.906, P = 0.042]. ROC curve analysis showed that both of rScO2 and PAV had predictive value for the prognosis of brain function in patients with TBI (AUC was 0.796 and 0.780, respectively, both P < 0.01), and rScO2 combined with PAV had higher predictive value with the AUC of 0.851 (P < 0.01) than rScO2 or PAV alone, the sensitivity was 94.4% and the specificity was 62.5%. rScO2 and PAV were associated with early brain function prognosis in patients with TBI. The combination of two monitoring indicators can reliably assess the prognosis of brain function in patients with TBI.

P34-T Serial EEG findings in patients with anti-NMDAR encephalitis

Serial EEG findings in patients with anti-NMDAR encephalitis. Background Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable but often misdiagnosed autoimmune encephalitis. Patients present with neuropsychiatric symptoms, impaired consciousness, seizures, autonomic instability, and hypoventilation Electroencephalogram (EEG) abnormalities are very common in anti-NMDAR encephalitis and may contribute to diagnosis at early stages of disease. The aim of the study was to describe serial EEG findings of in patients with anti-NMDAR encephalitis. Material and methods We present detailed clinical, electroencephalographical characteristics and long-term follow-up of five patients with confirmed anti-NMDAR encephalitis. Results All patients had abnormal EEG. The main presentations of abnormal EEG were diffuse slowing, epileptiform discharges, extreme delta brush, polymorphic delta rhythm and focal slowing. The degree of abnormalities correlated with disease progression and diminished along with the clinical improvement. Conclusion The majority of anti-NMDAR encephalitis patients had abnormal EEG. EEG could sensitively reflect the abnormal brain functions of patients and could assist with early clinical diagnosis and prognosis prediction.

The CD33 genotype associated cognitive performance was bidirectionally modulated by intrinsic functional connectivity in the Alzheimer’s disease spectrum

CD33 is a susceptibility locus for late-onset Alzheimer's disease (AD). However, how the neural mechanism of CD33 affects cognition in the AD spectrum population remains unclear. We aimed to investigate the primary and interactive effects of the CD33 (rs3865444) genotype on brain function in patients with AD using global functional connectivity density (gFCD) mapping via resting-state functional magnetic resonance imaging. Furthermore, we used a conditional process analysis to identify the relationship among the CD33 genotype, gFCD, and cognition performance across the AD spectrum population. Compared to cognitively normal (CN) and mild cognitively impaired (MCI) subjects, patients with AD showed higher gFCD in the default mode network, and the CD33 genotype primarily influenced brain function in the fronto-striatal circuit. Importantly, an interaction between the CD33 genotype and AD was observed in the parahippocampal gyrus. During disease progression, the gFCD trajectories of the CD33 A + allele gradually decreased, whereas those of the CD33 CC allele displayed an inverted U-shaped curve. Furthermore, gFCD in the dorsal anterior cingulate cortex positively mediated the relationship between the CD33 genotype and cognition, while gFCD in the precuneus bidirectionally moderated the mediation in the AD spectrum. These findings provide new insights into the neural mechanisms underlying the influence of the CD33 genotype on cognitive performance and highlight the importance of precise therapeutic strategies for high-risk AD populations.